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Home My WebLink AboutZ-31418FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPA/~CY No: Z- 31418 Date: 01/27/06 THIS CERTIFIES that the building DWELLING AND ACCESSORY LAUREL (STREET) (HAMLET) Block 0001 Lot 006.002 Location of Property 3805 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 125 Filed Map No. -- Lot No. -- Subdivision conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pttrsuant to which CERTIFICATE OF OCCUPANCYNUI~BER Z- 31418 dated JANUARY 27, 2006 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH SCREEN PORCH AND ACCESSORY ONE CAR GARAGE WITH ATTACHED SHED.* The certificate is issued to MARIAN G & ORS YOUNG (OWNER) of the aforesaid building. SuF~OLKCOI3NT~DEPARTMENTOFHI~a_STHAPPROVAL ELEc*~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'~'~u *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A N/A ature BUILDING DEPARTMENT TOWN OF SOUTROLD ROUSING CODE INSPECTION REPORT LAUREL ~.: LOT (S) K~ A~I~BLE: ~UFm. CO. TAX ~ NO.: 125.41-6.2 SO, CE OF P~: MYRON YOUNG DATE: 01/27/06 ACCESSORY STRUCTURES: C~. TYP~ OF C~ST.: WOOD FRAME - ONE CAR STOP~. ~"fPE CONST.: WOOD FRAME ATT. TO GAP. AGE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORR FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DAW (~ I]~NP~TIO~: 01/26/06 ~U][~ NT/~T: 9:40 AM ]~: 10:05 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · tAN I 8 "" APPLICATION FOR CERTIFICATE OF OCCUPANC~1 L ...... ':'~?T." I T(:'. ~ ,~QU I'riOLD This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% Icad. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer respousiblc for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state thc reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: ~ (check one) Location of Property: ) ~9' ~ .C ~/~. ~, /'~ ,, ,~ ,~ ~-~'~ / House No. Street H~et Own~or Own~s ofProp~: Fs~?~/~ ~ ~o~*~ ~'~/ ~ ~ ~j~ ~ ~ Suffolk Co~ty T~ Map No 1000, S~tion / ~ Bl~k ~ I- Lot ~, ~ Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ / tO a ,, a ~ Final Certificate: (check one) CONSENT TO INSPECTION P' ~,,../. p -/~oS.~,- -"/Ion, the undersigned, do(es) hereby state: Owner(s) Name(s) '~ -- That the undersigned (is) (are) the owner(s) offthe premises in the Town of Southold, locatedat ,f~3- /P]~/~ /2o.,~' ~ /[.~a~t,~../ / ~ Y which is shown and designated on the Suffolk Counts; Tax Map as District 1000, Section ! fl_ ~- , Block ~ ~ -- , Lot g~. 2. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: da ~- /'~ .2-00 ~ (Print Name) ~JoA ~®N ~o ®le:lS ®q.L :I/N h'~ .OL,£go61* N $,aJpuv ueS uuA-I ~ $!n"1 ..-I/N